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A02912 Summary:

BILL NOA02912A
 
SAME ASSAME AS S00298-B
 
SPONSORPaulin (MS)
 
COSPNSROrtiz, Hevesi, Bronson
 
MLTSPNSRDinowitz, Lifton
 
Amd 2164 & 613, Pub Health L
 
Provides for the immunization of all children born after January 1, 2009 with the human papillomavirus (HPV).
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A02912 Actions:

BILL NOA02912A
 
01/28/2019referred to health
11/15/2019amend and recommit to health
11/15/2019print number 2912a
01/08/2020referred to health
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A02912 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A2912A
 
SPONSOR: Paulin (MS)
  TITLE OF BILL: An act to amend the public health law, in relation to requiring immuni- zation against human papillomavirus (HPV)   SUMMARY OF SPECIFIC PROVISIONS:: Section one of this bill amends section 2164 of the Public Health Law to require persons in parental relation to children born on or after Janu- ary 1, 2009 who are entering or have entered seventh grade or a compara- ble age level special education program on or after September 1st, 2021 to have administered to such children an adequate dose or doses of immunizing agents against human papillomavirus (HPV). Section two of this bill makes conforming changes to ensure that the changes that section one of this bill makes to subdivision 7 of section 2164 of the Public Health Law remain in effect after certain provisions of such subdivision are repealed in 2020. Section three of this bill amends paragraph (a) of subdivision 1 of section 613 of the public health law by adding HPV to the list of commu- nicable diseases against which the commissioner of health shall develop and supervise the execution of a program of immunization, surveillance and testing in order to raise to the highest reasonable level the immu- nity of children in the state. Section four provides the effective date, and specifies that the changes made by sections one and two of this bill only apply to children born on or after January 1, 2009.   JUSTIFICATION:: Human papillomavirus (HPV) is an incredibly common sexually transmitted infection (STI) that can be passed even when an infected person is asymptomatic, and can cause genital warts or cancer. The Centers for Disease Control and Prevention (CDC) estimates that 79 million Americans are infected with HPV, most of whom are in their late teens and early twenties. The American Cancer Society (ACS) estimates that four out of five people will get HPV at some point in their lives. According to the CDC, HPV causes nearly 35,000 new cases of cancer each year in the U.S. in both men and women (About 20,700 cases in women and 14,100 cases in men), on parts of the body including the cervix, vagina, vulva, penis, anus, rectum, and oropharynx. The CDC also notes that in 2016 (the most recent year for which data is available), 12,984 new cases of cervical cancer were reported in the U.S., and approximately 4,188 women died of cervical cancer. In New York State, there were 824 cases of cervical cancer and 264 related deaths in 2016. The World Health Organization (WHO) notes that cervical cancer is "the fourth most frequent cancer in women with an estimated 570,000 new cases in 2018 representing 6.6% of all female cancers." According to the ACS, 99.7% of all cervical cancer cases are linked to HPV. The ACS estimates that at least 80% of sexually active women in the United States will have HPV by age 50, with most cases acquired soon after individuals have sex for the first time. While the majority of cases resolve on their own, for women whose body defenses are not suffi- cient to clear the virus, cervical cancer can develop later in life, as it can take up to 20 years for an HPV infection to cause cervical cancer. In summation, HPV infection is widespread, and poses real dangers and health risks for both men and women. Thankfully, there is an immediate solution to this problem. The CDC estimates that routine vaccination could prevent 92% of cancers caused by HPV, saving thousands of lives. ACS, the WHO, and countless other public health experts concur that routine vaccination is one of our best defenses against HPV - caused cancers and infections. The CDC's Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination against HPV for both girls and boys 11-12 years of age, though the vaccine can be given to children as young as 9 years old in cases where such children have a history of sexual abuse or a ssault. This is because the vaccine is most effective when it is administered prior to its recipient becoming sexually active. According to the CDC, each vaccine against HPV that the FDA has licensed for use went through "years of extensive safety testing" and was found to be safe and effective in clinical trials. More than a decade after the first HPV vaccine was approved for use, studies and meta-analyses of currently available data continue to show that the HPV vaccine is safe, and has resulted in compelling public health benefits and significantly decreased rates of HPV prevalence and new diagnoses. In fact, a comprehensive study published by Australian public health officials in 2017 outlined the extensive benefits of prophylactic HPV vaccination programs and recommended that "all countries consider and promote national guidelines and programs to prevent HPV-related diseases." Australia was one of the first countries to implement a school-based HPV vaccination program, and has seen a drop of up to 86% in the prevalence of HPV infections among those receiving the vaccine. This bill would require all children born on or after January 1, 2009 who are entering or have entered the seventh grade in New York State on or after September 1, 2021 to receive the HPV vaccine in order to attend school. School-based requirements are one of the most effective ways to ensure comprehensive immunization coverage in a society, and it is well within the purview of New York State government to act proactively in this matter to protect public health and prevent future cancer diag- noses. This approach also has precedent in the United States, as Virgi- nia, Rhode Island, and the District of Columbia currently require students to be vaccinated against HPV in order to attend school, and Hawaii will join them starting in the summer of 2020. Legislation to require this practice is also currently pending in at least seven other states.   PRIOR LEGISLATIVE HISTORY:: A.933, 2017 and 2018, referred to health. A.1822, 2016 and 2017 referred to health. A.2067, 2013 and 2014 referred to health. A.699, 2011 and 2012 referred to health. A.778, 2009 and 2010 referred to health. A.5810, 2007 and 2008 referred to health.   FISCAL IMPLICATION:: Minimal to the State, offset by future healthcare costs related to the treatment of cervical cancer and other cancers caused by HPV.   EFFECTIVE DATE:: This act shall take effect on September 1, 2021.
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A02912 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         2912--A
 
                               2019-2020 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 28, 2019
                                       ___________
 
        Introduced  by  M. of A. PAULIN, GUNTHER, ORTIZ -- Multi-Sponsored by --
          M. of A.  DINOWITZ, LIFTON -- read once and referred to the  Committee
          on  Health -- committee discharged, bill amended, ordered reprinted as
          amended and recommitted to said committee
 
        AN ACT to amend the public health law, in relation to requiring  immuni-
          zation against human papillomavirus (HPV)
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Section 2164 of the public health law, as amended by  chap-
     2  ter  401 of the laws of 2015, subdivisions 6 and 7 as amended by chapter
     3  35 of the laws of 2019, is amended to read as follows:
     4    §  2164.  Definitions;  immunization  against  poliomyelitis,   mumps,
     5  measles,  diphtheria,  rubella, varicella, Haemophilus influenzae type b
     6  (Hib), pertussis, tetanus, pneumococcal disease, meningococcal  disease,
     7  [and]  hepatitis  B  and human papillomavirus (HPV). 1.  As used in this
     8  section, unless the context requires otherwise:
     9    a. The term "school" means and includes any public, private  or  paro-
    10  chial child caring center, day nursery, day care agency, nursery school,
    11  kindergarten, elementary, intermediate or secondary school.
    12    b. The term "child" shall mean and include any person between the ages
    13  of two months and eighteen years.
    14    c.  The  term  "person in parental relation to a child" shall mean and
    15  include his  father  or  mother,  by  birth  or  adoption,  his  legally
    16  appointed  guardian, or his custodian. A person shall be regarded as the
    17  custodian of a child if he has assumed the charge and care of the  child
    18  because  the  parents  or  legally  appointed guardian of the minor have
    19  died, are imprisoned, are mentally ill, or have  been  committed  to  an
    20  institution,  or  because  they have abandoned or deserted such child or
    21  are living outside the state or their whereabouts are unknown,  or  have
    22  designated the person pursuant to title fifteen-A of article five of the
    23  general obligations law as a person in parental relation to the child.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD03954-10-9

        A. 2912--A                          2
 
     1    d.  The term "health practitioner" shall mean any person authorized by
     2  law to administer an immunization.
     3    2. a. Every person in parental relation to a child in this state shall
     4  have administered to such child an adequate dose or doses of an immuniz-
     5  ing  agent  against  poliomyelitis, mumps, measles, diphtheria, rubella,
     6  varicella, Haemophilus influenzae  type  b  (Hib),  pertussis,  tetanus,
     7  pneumococcal  disease,  and  hepatitis  B,  which  meets  the  standards
     8  approved by the United States public health service for such  biological
     9  products,  and which is approved by the department under such conditions
    10  as may be specified by the public health and health planning council.
    11    b. Every person in parental relation to a child in this state born  on
    12  or  after January first, nineteen hundred ninety-four and entering sixth
    13  grade or a comparable age level special education program with an  unas-
    14  signed grade on or after September first, two thousand seven, shall have
    15  administered  to such child a booster immunization containing diphtheria
    16  and tetanus toxoids, and an acellular pertussis vaccine, which meets the
    17  standards approved by the United States public health service  for  such
    18  biological  products, and which is approved by the department under such
    19  conditions as may be specified by the public health and health  planning
    20  council.
    21    c. Every person in parental relation to a child in this state entering
    22  or  having  entered  seventh grade and twelfth grade or a comparable age
    23  level special education program with an unassigned  grade  on  or  after
    24  September  first,  two thousand sixteen, shall have administered to such
    25  child an adequate dose or doses of immunizing agents against meningococ-
    26  cal disease as recommended by the  advisory  committee  on  immunization
    27  practices of the centers for disease control and prevention, which meets
    28  the  standards  approved  by the United States public health service for
    29  such biological products, and which is approved by the department  under
    30  such  conditions  as  may  be  specified by the public health and health
    31  planning council.
    32    d. Every person in parental relation to a child in this state entering
    33  or having entered seventh grade or a comparable age level special educa-
    34  tion program with an unassigned grade on or after September  first,  two
    35  thousand  twenty-one,  shall have administered to such child an adequate
    36  dose or doses of immunizing agents against human papillomavirus (HPV) as
    37  recommended by the advisory committee on immunization practices  of  the
    38  centers  for  disease  control and prevention, which meets the standards
    39  approved by the United States public health service for such  biological
    40  products,  and which is approved by the department under such conditions
    41  as may be specified by the public health and health planning council.
    42    3. The person in parental relation to  any  such  child  who  has  not
    43  previously  received  such  immunization  shall  present  the child to a
    44  health practitioner and request such health practitioner  to  administer
    45  the   necessary  immunization  against  poliomyelitis,  mumps,  measles,
    46  diphtheria, Haemophilus influenzae type  b  (Hib),  rubella,  varicella,
    47  pertussis,  tetanus,  pneumococcal disease, meningococcal disease, [and]
    48  hepatitis B and human papillomavirus (HPV) as  provided  in  subdivision
    49  two of this section.
    50    4.  If  any person in parental relation to such child is unable to pay
    51  for the services of a private health  practitioner,  such  person  shall
    52  present  such  child  to  the  health officer of the county in which the
    53  child resides, who shall then administer the  immunizing  agent  without
    54  charge.
    55    5.  The  health  practitioner  who  administers  such immunizing agent
    56  against poliomyelitis, mumps, measles, diphtheria, Haemophilus  influen-

        A. 2912--A                          3
 
     1  zae  type  b (Hib), rubella, varicella, pertussis, tetanus, pneumococcal
     2  disease, meningococcal disease, [and] hepatitis B and human papillomavi-
     3  rus (HPV) to any such child shall give a certificate of  such  immuniza-
     4  tion to the person in parental relation to such child.
     5    6.  In  the  event that a person in parental relation to a child makes
     6  application for admission of such child to  a  school  or  has  a  child
     7  attending  school  and  there  exists no certificate or other acceptable
     8  evidence of  the  child's  immunization  against  poliomyelitis,  mumps,
     9  measles,  diphtheria,  rubella, varicella, hepatitis B, pertussis, teta-
    10  nus, and, where applicable, Haemophilus influenzae type b (Hib),  menin-
    11  gococcal  disease,  [and]  pneumococcal disease and human papillomavirus
    12  (HPV), the principal, teacher, owner or person in charge of  the  school
    13  shall  inform  such person of the necessity to have the child immunized,
    14  that such immunization may be administered by any  health  practitioner,
    15  or  that the child may be immunized without charge by the health officer
    16  in the county where the child resides, if such person executes a consent
    17  therefor. In the event that such person does not wish to select a health
    18  practitioner to administer the immunization, he or she shall be provided
    19  with a form which shall give notice that as a prerequisite to processing
    20  the application for admission to, or for continued  attendance  at,  the
    21  school such person shall state a valid reason for withholding consent or
    22  consent  shall  be given for immunization to be administered by a health
    23  officer in the public employ, or by a school  physician  or  nurse.  The
    24  form  shall provide for the execution of a consent by such person and it
    25  shall also state that such person  need  not  execute  such  consent  if
    26  subdivision eight of this section applies to such child.
    27    7.  (a)  No  principal, teacher, owner or person in charge of a school
    28  shall permit any child to be admitted to such school, or to attend  such
    29  school, in excess of fourteen days, without the certificate provided for
    30  in subdivision five of this section or some other acceptable evidence of
    31  the child's immunization against poliomyelitis, mumps, measles, diphthe-
    32  ria,  rubella,  varicella,  hepatitis  B, pertussis, tetanus, and, where
    33  applicable, Haemophilus influenzae type b (Hib), meningococcal  disease,
    34  [and]  pneumococcal  disease  and  human papillomavirus (HPV); provided,
    35  however, such fourteen day period may be extended to not more than thir-
    36  ty days for an individual student by the appropriate principal, teacher,
    37  owner or other person in charge where such student is transferring  from
    38  out-of-state or from another country and can show a good faith effort to
    39  get  the  necessary  certification  or other evidence of immunization or
    40  where the parent, guardian, or any other person in parental relationship
    41  to such child can demonstrate that a child has  received  at  least  the
    42  first  dose in each immunization series required by this section and has
    43  age appropriate appointments  scheduled  to  complete  the  immunization
    44  series  according  to  the  Advisory Committee on Immunization Practices
    45  Recommended Immunization Schedules for Persons Aged 0 through 18 Years.
    46    (b) A parent, a guardian or any other person in parental  relationship
    47  to  a  child denied school entrance or attendance may appeal by petition
    48  to the commissioner of education in accordance with  the  provisions  of
    49  section three hundred ten of the education law.
    50    8. If any physician licensed to practice medicine in this state certi-
    51  fies  that such immunization may be detrimental to a child's health, the
    52  requirements of this section shall be inapplicable until such  immuniza-
    53  tion is found no longer to be detrimental to the child's health.
    54    8-a.  Whenever  a  child  has  been refused admission to, or continued
    55  attendance at, a school as provided for in  subdivision  seven  of  this
    56  section  because there exists no certificate provided for in subdivision

        A. 2912--A                          4
 
     1  five of this section or other acceptable evidence of the child's immuni-
     2  zation against poliomyelitis, mumps, measles, diphtheria, rubella, vari-
     3  cella, hepatitis B, pertussis, tetanus, and, where applicable, Haemophi-
     4  lus  influenzae  type b (Hib), meningococcal disease, [and] pneumococcal
     5  disease and human papillomavirus (HPV), the principal, teacher, owner or
     6  person in charge of the school shall:
     7    a. forward a report of such exclusion and the name and address of such
     8  child to the local health  authority  and  to  the  person  in  parental
     9  relation to the child together with a notification of the responsibility
    10  of  such  person  under  subdivision  two  of this section and a form of
    11  consent as prescribed by regulation of the commissioner, and
    12    b. provide, with the  cooperation  of  the  appropriate  local  health
    13  authority,  for  a time and place at which an immunizing agent or agents
    14  shall be administered, as required by subdivision two of  this  section,
    15  to a child for whom a consent has been obtained. Upon failure of a local
    16  health authority to cooperate in arranging for a time and place at which
    17  an  immunizing  agent  or  agents  shall  be administered as required by
    18  subdivision two of this section, the commissioner shall arrange for such
    19  administration and may recover the cost thereof from the amount of state
    20  aid to which the local health authority would otherwise be entitled.
    21    10. The commissioner may adopt and  amend  rules  and  regulations  to
    22  effectuate the provisions and purposes of this section.
    23    11.  Every  school  shall  annually provide the commissioner, on forms
    24  provided by the commissioner, a summary regarding  compliance  with  the
    25  provisions of this section.
    26    §  2.    Subdivision  7  of  section 2164 of the public health law, as
    27  amended by chapter 401 of the laws  of  2015,  is  amended  to  read  as
    28  follows:
    29    7.  (a)  No  principal, teacher, owner or person in charge of a school
    30  shall permit any child to be admitted to such school, or to attend  such
    31  school, in excess of fourteen days, without the certificate provided for
    32  in subdivision five of this section or some other acceptable evidence of
    33  the child's immunization against poliomyelitis, mumps, measles, diphthe-
    34  ria,  rubella,  varicella,  hepatitis  B, pertussis, tetanus, and, where
    35  applicable, Haemophilus influenzae type b (Hib), meningococcal  disease,
    36  [and]  pneumococcal  disease  and  human papillomavirus (HPV); provided,
    37  however, such fourteen day period may be extended to not more than thir-
    38  ty days for an individual student by the appropriate principal, teacher,
    39  owner or other person in charge where such student is transferring  from
    40  out-of-state or from another country and can show a good faith effort to
    41  get the necessary certification or other evidence of immunization.
    42    (b)  A parent, a guardian or any other person in parental relationship
    43  to a child denied school entrance or attendance may appeal  by  petition
    44  to  the  commissioner  of education in accordance with the provisions of
    45  section three hundred ten of the education law.
    46    § 3. Paragraph (a) of subdivision 1  of  section  613  of  the  public
    47  health law, as amended by section 24 of part E of chapter 56 of the laws
    48  of 2013, is amended to read as follows:
    49    (a)  The  commissioner  shall develop and supervise the execution of a
    50  program of immunization, surveillance and testing, to raise to the high-
    51  est reasonable level the immunity of the children of the  state  against
    52  communicable  diseases including, but not limited to, influenza, poliom-
    53  yelitis, measles, mumps, rubella, haemophilus influenzae type  b  (Hib),
    54  diphtheria,  pertussis,  tetanus,  varicella,  hepatitis B, pneumococcal
    55  disease, human papillomavirus (HPV), and the immunity of adults  of  the
    56  state against diseases identified by the commissioner, including but not

        A. 2912--A                          5
 
     1  limited to influenza, smallpox, hepatitis and such other diseases as the
     2  commissioner  may  designate through regulation.   Municipalities in the
     3  state shall maintain local programs of immunization to raise the immuni-
     4  ty  of  the  children  and  adults  of  each municipality to the highest
     5  reasonable level, in  accordance  with  an  application  for  state  aid
     6  submitted  by  the  municipality  and approved by the commissioner. Such
     7  programs shall include assurance of provision  of  vaccine,  serological
     8  testing  of  individuals  and  educational efforts to inform health care
     9  providers and target populations or their parents, if they  are  minors,
    10  of  the  facts  relative  to these diseases and immunizations to prevent
    11  their occurrence.
    12    § 4. This act shall take effect on September 1, 2021; provided, howev-
    13  er, that:
    14    a. sections one and two of this act shall apply only to children  born
    15  on or after January 1, 2009; and
    16    b.  the  amendments  to  subdivision  7  of section 2164 of the public
    17  health law made by section one of this act shall be subject to the expi-
    18  ration and reversion of such subdivision pursuant to section 4 of  chap-
    19  ter 35 of the laws of 2019 when upon such date the provisions of section
    20  two of this act shall take effect.
    21    Effective  immediately  the  addition,  amendment and/or repeal of any
    22  rule or regulation necessary for the implementation of this act  on  its
    23  effective date are authorized to be made and completed on or before such
    24  date.
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